术前血清CEA、CA19-9水平检测对胃癌术后复发转移及预后的意义  

Significance of Preoperative Serum CEA, CA19-9 Levels in Postoperative Recurrence and Metastasis and Prognosis for Gastric Cancer

作　　者：陈静[1] 张德巍[1] 张春东[1] 唐元新[1] 戴冬秋[1] 

机构地区：[1]中国医科大学附属第四医院胃肠外科,辽宁沈阳110032

出　　处：《中国普外基础与临床杂志》2015年第2期195-199,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨术前血清CEA和CA19-9水平在胃癌根治术后复发转移及预后中的应用价值。方法应用电化学发光法检测136例胃癌患者术前静脉血清CEA和CA19-9水平,分析CEA和CA19-9水平与患者临床病理学参数、术后复发转移和预后的关系。采用Kaplan-Meier法(log-rank检验)进行生存分析。结果 136例胃癌患者中术后复发转移67例。术前血清CEA阳性率为48.5%(66/136),CA19-9阳性率为43.4%(59/136)。CEA阳性与T分期、TNM分期、淋巴结转移及脉管浸润有关(P=0.011、P=0.018、P=0.021、P=0.024),CA19-9阳性与T分期和淋巴结转移有关(P=0.018、P=0.045)。CEA阳性组和CA19-9阳性组术后复发转移率分别为60.6%(40/66)和61.0%(36/59),CEA阴性组和CA19-9阴性组术后复发转移率分别为38.6%(27/70)和40.3%(31/77),CEA阳性组和CA19-9阳性组术后复发转移率分别明显高于CEA阴性组和CA19-9阴性组(P=0.010、P=0.016)。Kaplan-Meier生存分析显示CEA阳性组和CA19-9阳性组术后无瘤生存时间明显短于CEA阴性组和CA19-9阴性组(P=0.003、P=0.007)。结论术前血清CEA和CA19-9水平检测在胃癌术后复发转移和预后判断中具有重要价值,术前联合检测血清CEA和CA19-9水平有助于提高胃癌术后复发转移和预后的预测。Objective To investigate the values of serum CEA and CA19-9 in predicting postoperative recurrence and metastasis and prognosis for gastric cancer. Methods Preoperative serum levels of CEA and CA19-9 were measured by electrochemiluminescence assay in 136 patients with gastric cancer. The relationships of serum CEA level, CA19-9 level to clinicopathologic features, postoperative recurrence and metastasis, and prognosis of gastric cancer were analyzed. Kaplan-Meier method（log-rank test） was used to survival analysis. Results There were 67 patients with postoperative recurrence and metastasis in 136 patients with gastric cancer. The positive rate was 48.5%（66/136） for CEA and 43.4%（59/136） for CA19-9. There was a significant correlation between CEA level and T stage, TNM stage, lymph node metastasis, or vascular invasion（P=0.011, P=0.018, P=0.021, P=0.024）. There was a significant correlation between CA19-9level and T stage or lymph node metastasis（P=0.018, P=0.045）. The rate of postoperative recurrence and metastasis was 60.6%（40/66） in positive CEA, 61.0%（36/59） in positive CA19-9, 38.6%（27/70） in negative CEA, and 40.3%（31/77） in negative CA19-9, respectively. The rate of postoperative recurrence and metastasis in the positive CEA or positive CA19-9was significantly higher than those in the negative CEA or negative CA19-9（P=0.010, P=0.016）. Kaplan-Meier analysis showed that patients with positive CEA or positive CA19-9 had worse survival than those with negative CEA or CA19-9（P=0.003, P=0.007）. Conclusions CEA and CA19-9 have important values in detecting recurrence and metastasis, predicting patient survival after gastric cancer surgery. Combined analysis of these markers is considered to be helpful for improving the prediction of the postoperative recurrence and metastasis and prognosis of gastric cancer.

关 键 词：胃癌 CEA CA19-9 复发转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]